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Examine beliefs about the power of voices — challenging omniscience, omnipotence, and the need to comply.
Distress from voices is often related to beliefs about how powerful they are, not the voices themselves. This worksheet helps you examine your beliefs about the voice's power, knowledge, and control — and test whether these beliefs are accurate.
Use when working with clients who hear commanding or distressing voices. The power differential worksheet helps clients explore their relationship with voices, examining beliefs about the voice's power, omniscience, and authority relative to their own.
Frame as exploring the relationship between the client and the voice(s), similar to how we might examine any relationship. Use Birchwood's framework to rate perceived power, knowledge, and control of the voice versus the self. Approach with genuine curiosity and respect for the client's experience.
For clients who hear multiple voices, work with one voice at a time, starting with the most distressing. For those who find the voice too frightening to discuss directly, use indirect approaches (e.g., writing rather than speaking, discussing 'what the voice claims' rather than 'what the voice knows').
Do not use if discussing voice power significantly increases the client's distress or compliance with harmful voice commands. Ensure safety planning is in place if voices command self-harm or harm to others. If the client is not ready to question the voice's authority, focus on coping strategies first.
The key therapeutic target is the belief that the voice is omnipotent and must be obeyed. Behavioural experiments that test the voice's claimed powers (e.g., 'the voice says it will punish me if I don't obey — what actually happens?') can be powerful but must be carefully graded and supported. Track changes in power beliefs over time.
Suitable for clients working with psychosis, cbtp, voices, power differential, beliefs about voices, chadwick. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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